MEDICARE: BRITTLEY LACOLE BURROWS I

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency	401701091114	OH

General Provider Information

NPI Number	:	1548124589
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRITTLEY LACOLE BURROWS I

Provider Business Mailing Address
First Line	:	1722 HENRY AVE SW
Second Line	:
City	:	CANTON
State	:	OH
Zip	:	44706-2938
Country	:	US
Telephone Number	:	330-412-6100
Fax Number	:

Provider Business Practice Location Address
First Line	:	1722 HENRY AVE SW
Second Line	:
City	:	CANTON
State	:	OH
Zip	:	44706-2938
Country	:	US
Telephone Number	:	330-412-6100
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/15/2025
Last Update Date	:	12/15/2025

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Directions to “ BRITTLEY LACOLE BURROWS I ” Practice Location

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